| NPI | 1417684895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MT PHA-PHA-LIC-102645) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03442323) |
| Enumeration Date | 2022-08-04 |
| Last Update Date | 2024-06-12 |